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Hernia : the Journal of Hernias and... Aug 2023There is an increasing number of patients following hernia surgery with implanted mesh reporting symptoms that could indicate autoimmune or allergic reactions to mesh.... (Review)
Review
BACKGROUND
There is an increasing number of patients following hernia surgery with implanted mesh reporting symptoms that could indicate autoimmune or allergic reactions to mesh. 'Allergy' to metals, various drugs, and chemicals is well recognised. However, hypersensitivity, allergy or autoimmunity caused by surgical mesh has not been proven by a scientific method to date. The aim of this study was twofold: to describe the pathophysiology of autoimmunity and foreign body reaction and to undertake a systematic review of surgical mesh implanted at the time of hernia repair and the subsequent development of autoimmune disease.
METHODS
A systematic review using the PRISMA guidelines was undertaken. Pubmed (Medline), Google Scholar and Cochrane databases were searched for all English-written peer-reviewed articles published between 2000 and 2021. The search was performed using the keywords "hernia", "mesh", "autoimmunity", "ASIA", "immune response", "autoimmune response".
RESULTS
Seven papers were included in the final analysis-three systematic reviews, three cohort studies and one case report. Much of the current data regarding the association of hernia mesh and autoimmunity relies on retrospective cohort studies and/or case reports with limited availability of cofounding factor data linked to autoimmune disease such as smoking status or indeed a detailed medical history of patients. Three systematic reviews have discussed this topic, each with a slightly different approach and none of them has identified causality between the use of mesh and the subsequent development of autoimmune disease.
CONCLUSION
There is little evidence that the use of polypropylene mesh can lead to autoimmunity. A large number of potential triggers of autoimmunity along with the genetic predisposition to autoimmune disease and the commonality of hernia, make a cause and effect difficult to unravel at present. Biomaterials cause foreign body reactions, but a chronic foreign body reaction does not indicate autoimmunity, a common misunderstanding in the literature.
Topics: Humans; Retrospective Studies; Herniorrhaphy; Hernia, Inguinal; Foreign-Body Reaction; Surgical Mesh; Autoimmune Diseases
PubMed: 36739352
DOI: 10.1007/s10029-023-02749-4 -
Hernia : the Journal of Hernias and... Aug 2014Despite the vast selection of brands available, nearly all synthetic meshes for hernia surgery continue to use one or other of three basic materials: polypropylene,... (Review)
Review
PURPOSE
Despite the vast selection of brands available, nearly all synthetic meshes for hernia surgery continue to use one or other of three basic materials: polypropylene, polyester and ePTFE. These are used in combination with each other or with a range of additional materials such as titanium, omega 3, monocryl, PVDF and hyaluronate. This systematic review of all experimental and clinical studies is aimed at investigating whether titanized meshes confer advantages over other synthetic meshes in hernia surgery.
MATERIALS AND METHODS
A search of the medical literature from 2002 to 2012, as indexed by Medline, was performed, using the PubMed search engine (http://www.pubmed.gov). The search terms were: hernia mesh, titanium coating, lightweight mesh, TiMesh, mesh complications. All papers were graded according to the Oxford hierarchy of evidence.
RESULTS
Patients operated on with the Lichtenstein technique performed using the lightweight titanium-coated mesh have a shorter convalescence than those with the heavy-weight mesh Prolene. For inguinal hernias operated on with the TAPP technique and using a lightweight titanium-coated mesh in comparison to a heavy-weight Prolene mesh, the early postoperative convalescence seems to improve. Titanized meshes do exhibit a negative effect on sperm motility 1 year after a TEP operation, but not after 3 years. The laparoscopic IPOM technique with a titanium-coated polypropylene mesh was associated with less postoperative pain in the short term, lower analgesic consumption and a quicker return to everyday activities compared with the Parietex composite mesh.
CONCLUSION
In clinical studies, the titanium-coated polypropylene mesh shows in inguinal hernia repair certain benefits compared with the use of older heavy-weight meshes.
Topics: Biocompatible Materials; Hernia, Inguinal; Herniorrhaphy; Humans; Polypropylenes; Surgical Mesh; Titanium
PubMed: 24253381
DOI: 10.1007/s10029-013-1187-3 -
Materials (Basel, Switzerland) Jul 2022The high cost of biofabricated titanium mesh plates can make them out of reach for hospitals in low-income countries. To increase the availability of cranioplasty, the... (Review)
Review
The high cost of biofabricated titanium mesh plates can make them out of reach for hospitals in low-income countries. To increase the availability of cranioplasty, the authors of this work investigated the production of polymer-based endoprostheses. Recently, cheap, popular desktop 3D printers have generated sufficient opportunities to provide patients with on-demand and on-site help. This study also examines the technologies of 3D printing, including SLM, SLS, FFF, DLP, and SLA. The authors focused their interest on the materials in fabrication, which include PLA, ABS, PET-G, PEEK, and PMMA. Three-dimensional printed prostheses are modeled using widely available CAD software with the help of patient-specific DICOM files. Even though the topic is insufficiently researched, it can be perceived as a relatively safe procedure with a minimal complication rate. There have also been some initial studies on the costs and legal regulations. Early case studies provide information on dozens of patients living with self-made prostheses and who are experiencing significant improvements in their quality of life. Budget 3D-printed endoprostheses are reliable and are reported to be significantly cheaper than the popular counterparts manufactured from polypropylene polyester.
PubMed: 35888198
DOI: 10.3390/ma15144731 -
Medical Devices (Auckland, N.Z.) 2019Controversy exists regarding the outcomes following ventral hernia repair with polypropylene (PP) or polyester (PET) mesh. Monofilament PP less frequently requires...
PURPOSE
Controversy exists regarding the outcomes following ventral hernia repair with polypropylene (PP) or polyester (PET) mesh. Monofilament PP less frequently requires extraction in the setting of contamination compared to multifilament PET mesh. The purpose of this systematic review and meta-analysis was to analyze the clinical outcomes of ventral hernia repair with PP and PET mesh.
PATIENTS AND METHODS
A comprehensive literature search was performed using the Ovid search platform. Criteria included ventral hernia repair publications using either PP or PET mesh with a minimum follow-up duration of one year. Included studies were subject to data extraction including mesh position, weight, recurrence rates, infection, and complications. Random effect meta-analysis was run to provide pooled event rate and 95% CI.
RESULTS
Ninety-seven studies including a total of 10,022 patients were included in the final analysis. Hernia recurrence rates are similar (4.8%, 95% CI [3.5-6.5] vs 4.7%, 95% CI [3.7-6.0]) as well as mesh infection rates (3.5%, 95% CI [2.5-4.9] vs 5.0%, 95% CI [3.9-6.3]) between PET and PP, respectively. Mesh infections occurred less frequently in laparoscopic repair compared to open (1.6%, 95% CI [0.9-2.6] vs 5.2%, 95% CI [4.3-6.3]).
CONCLUSION
This study suggests that mesh material does not affect recurrence or infection in ventral hernia repair and that surgery can be safely performed with both PP and PET mesh. A laparoscopic approach is associated with a decreased infection rate compared to open repair independent of mesh type.
PubMed: 31572024
DOI: 10.2147/MDER.S198988 -
PloS One 2015A systematic review and meta-analysis was performed in randomized controlled trials (RCTs) to compare porcine small intestinal submucosa (SIS) with polypropylene in open... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND
A systematic review and meta-analysis was performed in randomized controlled trials (RCTs) to compare porcine small intestinal submucosa (SIS) with polypropylene in open inguinal hernia repair.
METHOD
Electronic databases MEDLINE, Embase, and the Cochrane Library were used to compare patient outcomes for the two groups via meta-analysis.
RESULT
A total of 3 randomized controlled trials encompassing 200 patients were included in the meta-analysis. There was no significant difference in recurrence (P = 0.16), hematomas (P = 0.06), postoperative pain within 30 days (P = 0.45), or postoperative pain after 1 year (P = 0.12) between the 2 groups. The incidence of discomfort was significantly lower (P = 0.0006) in the SIS group. However, the SIS group experienced a significantly higher incidence of seroma (P = 0.03).
CONCLUSIONS
Compared to polypropylene, using SIS in open inguinal hernia repair is associated with a lower incidence of discomfort and a higher incidence of seroma. However, well-designed larger RCT studies with a longer follow-up period are needed to confirm these findings.
Topics: Animals; Databases, Factual; Hematoma; Herniorrhaphy; Humans; Intestine, Small; Odds Ratio; Pain, Postoperative; Polypropylenes; Randomized Controlled Trials as Topic; Recurrence; Seroma; Surgical Mesh; Swine; Treatment Outcome
PubMed: 26252895
DOI: 10.1371/journal.pone.0135073 -
Hernia : the Journal of Hernias and... Apr 2022The surgical implantation of polypropylene (PP) meshes has been linked to the occurrence of systemic autoimmune disorders. We performed a systematic review to determine... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The surgical implantation of polypropylene (PP) meshes has been linked to the occurrence of systemic autoimmune disorders. We performed a systematic review to determine whether PP implants for inguinal, ventral hernia or pelvic floor surgery are associated with the development of systemic autoimmune syndromes.
METHODS
We searched Embase, Medline, Web of Science, Scopus, Cochrane library, clinicaltrialsregister.eu, clinicaltrails.gov and WHO-ICTR platform. Last search was performed on November 24th 2021. All types of studies reporting systemic inflammatory/autoimmune response in patients having a PP implant for either pelvic floor surgery, ventral or inguinal hernia repair were included. Animal studies, case reports and articles without full text were excluded. We intended to perform a meta-analysis. The quality of evidence was assessed with the Newcastle-Ottawa Scale. This study was registered at Prospero (CRD42020220705).
RESULTS
Of 2137 records identified, 4 were eligible. Two retrospective matched cohort studies focused on mesh surgery for vaginal prolapse or inguinal hernia compared to hysterectomy and colonoscopy, respectively. One cohort study compared the incidence of systemic conditions in women having urinary incontinence surgery with and without mesh. These reports had a low risk of bias. A meta-analysis showed no association when comparing systemic disease between mesh and control groups. Calculated risk ratio was 0.9 (95% CI 0.82-0.98). The fourth study was a case series with a high risk of bias, with a sample of 714 patients with systemic disease, 40 of whom had PP mesh implanted.
CONCLUSION
There is no evidence to suggest a causal relationship between being implanted with a PP mesh and the occurrence of autoimmune disorders.
Topics: Animals; Autoimmune Diseases; Cohort Studies; Female; Hernia, Inguinal; Herniorrhaphy; Humans; Polypropylenes; Retrospective Studies; Surgical Mesh; Syndrome
PubMed: 35020091
DOI: 10.1007/s10029-021-02553-y -
Journal of Environmental Health Science... Dec 2023Pollution of the environment with all kinds of plastics has become a growing problem. The problem of microplastics is mainly due to the absorption of stable organic...
PURPOSE
Pollution of the environment with all kinds of plastics has become a growing problem. The problem of microplastics is mainly due to the absorption of stable organic pollutants and metals into them, and as a result, their environmental toxicity increases. The main purpose of this study is to investigate the appropriate and efficient methods of removing microplastics from aqueous environments through a systematic review.
METHODS
Present study designed according to PRISMA guidelines. Two independent researchers followed all process from search to final analysis, for the relevant studies using international databases of PubMed, Scopus and ISI/WOS (Web of Science), without time limit. The search strategy developed based on the main axis of "microplastics", "aqueous environments" and "removal". This research was carried out from 2017 until the March of 2022. All relevant observational, analytical studies, review articles, and a meta-analysis were included.
RESULTS
Through a comprehensive systematic search we found 2974 papers, after running the proses of refining, 80 eligible papers included to the study. According to the results of the review, the methods of removing microplastics from aquatic environments were divided to physical (12), chemical (18), physicochemical (27), biological (12) and integrated (11) methods. In different removal methods, the most dominant group of studied microplastics belonged to the four groups of polyethylene (PE), polystyrene (PS), polypropylene (PP) and polyethylene tetra phthalate (PET). Average removal efficiency of microplastics in different processes in each method was as: physical method (73.76%), chemical method (74.38%), physicochemical method (80.44%), biological method (75.23%) and integrated method (88.63%). The highest removal efficiency occurred in the processes based on the integrated method and the lowest efficiency occurred in the physical method. In total, 80% of the studies were conducted on a laboratory scale, 18.75% on a full scale and 1.25% on a pilot scale.
CONCLUSION
According to the findings; different processes based on physical, chemical, physicochemical, biological and integrated methods are able to remove microplastics with high efficiency from aqueous environments and in order to reduce their hazardous effects on health and environment, these processes can be easily used.
PubMed: 37869596
DOI: 10.1007/s40201-023-00872-z -
Environmental Pollution (Barking, Essex... Dec 2022Coastal lagoons are transitional environments between continental and marine aquatic systems. Globally, coastal lagoons are of great ecological and socioeconomic... (Review)
Review
Coastal lagoons are transitional environments between continental and marine aquatic systems. Globally, coastal lagoons are of great ecological and socioeconomic importance as providers of valuable ecosystem services. However, these fragile environments are subject to several human pressures, including pollution by microplastics (MPs). The aim of this review was to identify and summarize advances in MP pollution research in coastal lagoons across the world. We consider peer-reviewed publications on this topic published in English and Spanish between 2000 and April 21, 2022, available in Scopus and Google Scholar. We found 57 publications with data on MP abundances and their characteristics in 50 coastal lagoons from around the world, 58% of which have some environmental protection status. The number of publications on this type of pollution in lagoons has increased significantly since 2019. Methodological differences amongst studies of MPs in coastal lagoons were nevertheless a limiting factor for wide-ranging comparisons. Most studies (77%) were conducted in single environmental compartments, and integration was limited, hampering current understanding of MP dynamics in such lagoons. MPs were more abundant in lagoons with highly populated shores and watersheds, which support intensive human activities. On the contrary, lagoons in natural protected areas had lower abundances of MPs, mostly in sediments and organisms. Fiber/filament and fragment shapes, and polyethylene, polyester, and polypropylene polymers were predominant. MPs had accumulated in certain areas of coastal lagoons, or had been exported to the sea, depending on the influence of seasonal weather, hydrodynamics, anthropogenic pressures, and typology of MPs. It is advised that future research on MP pollution in coastal lagoons should focus on methodological aspects, assessment/monitoring of pollution itself, MP dynamics and impacts, and prevention measures as part of a sound environmental management.
Topics: Humans; Microplastics; Plastics; Geologic Sediments; Ecosystem; Water; Environmental Monitoring; Water Pollutants, Chemical; Polyethylene
PubMed: 36240966
DOI: 10.1016/j.envpol.2022.120366 -
European Journal of Trauma and... Dec 2022High clinical success rates have been reported with the Masquelet technique in the treatment of traumatic bone loss. An increasing number of studies suggest that various... (Review)
Review
PURPOSE
High clinical success rates have been reported with the Masquelet technique in the treatment of traumatic bone loss. An increasing number of studies suggest that various factors can influence the properties of induced membranes. Goal of this systematic review is to answer the following questions: (1) which are the ideal spacer properties (material, surface topography, antibiotic supplementation) to booster the quality and osteogenic potential of induced membranes? (2) what is the ideal time to perform the second-stage operation?
METHODS
A systematic search using the keywords "((Masquelet) OR (Induced Periosteum)) AND ((Spacer) OR (Time))" was performed in PubMed, Embase and Cochrane Library according to PRISMA guidelines. Studies published up to the 23rd of February 2022 were included and assessed independently by two reviewers.
RESULTS
Thirteen animal and 1 clinical studies were identified to address the above questions. Spacer materials used were PMMA, silicone, titanium, polypropylene, PVA, PCL and calcium sulfate. With the exception of PVA sponges, all solid materials could induce membranes. Low union rates have been reported with titanium and rough surfaced spacers. Scraping of the inner surface of the IM also increased bony union rates. In terms of the ideal timing to perform the second-stage evidence suggests that membranes older than 8 weeks continue to have regenerative capacities similar to younger ones.
CONCLUSION
Membranes induced by smooth PMMA spacers loaded with low concentrations of antibiotics showed powerful osteogenic properties. Other materials such as Polypropylene or Calcium sulfate can also be used with good results. Despite current recommendation to perform the second stage operation in 4-8 weeks, membranes older than 8 weeks seem to have similar regenerative capacities to younger ones.
Topics: Animals; Polymethyl Methacrylate; Titanium; Calcium Sulfate; Polypropylenes
PubMed: 35726029
DOI: 10.1007/s00068-022-02005-x -
Journal of Pharmacy & Bioallied Sciences Feb 2024This systematic review examines the efficacy and biocompatibility of orthodontic clear aligner tooth aligners constructed from polyethylene terephthalate glycol (PeT-G),...
Effectiveness and Biocompatibility of Tooth Aligners Made from Polyethylene Terephthalate Glycol (PeT-G), Polypropylene (PP), Polycarbonate (PC), Thermoplastic Polyurethanes (TPUs), and Ethylene-Vinyl Acetate (EVA): A Systematic Review.
OBJECTIVE
This systematic review examines the efficacy and biocompatibility of orthodontic clear aligner tooth aligners constructed from polyethylene terephthalate glycol (PeT-G), polypropylene (PP), polycarbonate (PC), thermoplastic polyurethanes (TPUs), and ethylene-vinyl acetate (EVA).
MATERIALS AND METHODS
To find relevant papers published through September 2021, PubMed was searched extensively. Randomized clinical trials (RCTs) and observational studies assessing the effectiveness and biocompatibility of the aligner materials were included. Data were extracted independently, and the quality of included research was appraised using relevant procedures. The research variability necessitated a narrative synthesis.
RESULTS
Five studies were included for comparison. All materials were biocompatible; however, PeT-G and EVA aligners caused the least tissue irritation. Patients preferred TPU aligners for initial comfort and PeT-G aligners for transparency and endurance.
CONCLUSION
Biocompatible PeT-G, PP, PC, TPU, and EVA tooth aligners fix malocclusions. Aligner materials should be chosen based on patient preferences, treatment goals, and material qualities. For stronger proof, a longer-term study is needed.
PubMed: 38595485
DOI: 10.4103/jpbs.jpbs_883_23